Retinitis pigmentozalı hastalarda trombositten zengin plazma enjeksiyon uygulamaları

Amaç: Retinitis Pigmentozalı (RP) hastalarda subtenon otolog trombositten zengin plazma (PRP) enjeksiyonun görme keskinliği, görme alanı ve görmeye bağlı yaşam kalitesine (YK) etkisini değerlendirmektir. Yöntem: Bu retrospektif çalışmada, 2019-2021 tarihleri arasında 31 RP’li hastanın 60 gözüne iki haftalık aralıklarla üç defa subtenon otolog PRP enjeksiyonu uygulandı. PRP öncesi ve PRP enjeksiyonlarından bir ay sonra en iyi düzeltilmiş görme keskinlikleri (EİDGK) ve görme alanı değerleri [(mean deviation (MD) ve pattern standard deviation (PSD)] karşılaştırıldı. Bu hastalardan takiplerine devam eden 19’unun 36 gözüne son enjeksiyondan altı ay sonra ilave enjeksiyon uygulandı. Bu grupta PRP öncesi ve ilave enjeksiyon sonrası EİDGK, görme alanı değerleri ve görmeye bağlı YK puanları karşılaştırıldı. Bulgular: Ortanca (Q1-Q3) değerleri EİDGK için, PRP’den önce 0.80 (0.52-1.30) logMAR, sonra 0.80 (0.50-1.28) logMAR, MD için, önce -30.26 (-31.10 – -28.56), sonra -29.79 (-31.13 – -28.61) , PSD için, önce 6.27 (4.78 – 8.15) , sonra 6.59 (4.90 – 8.06) idi. EİDGK ve MD değerleri için aradaki fark istatistiksel olarak anlamlı idi (p<0.001, p=0.037, sırayla). İlave enjeksiyon yapılan grupta ilk PRP enjeksiyonu öncesi ve ilave enjeksiyon sonrası EİDGK ve görmeye bağlı YK için aradaki fark istatistiksel olarak anlamlı , MD için anlamlı değildi (p<0.005;p<0.001; p=0.393;sırayla). Uygulamayla ilişkili oftalmolojik ve sistemik bir komplikasyon görülmedi. Sonuç: Subtenon otolog PRP enjeksiyonunun, Retinitis pigmentozalı hastalarda görsel fonksiyonlar ve yaşam kalitesi üzerinde olumlu etkisi olabilir. Ancak tedavinin etkililiği ve uygulama sıklığının belirlenmesi için daha geniş katılımlı ve daha uzun takip süreli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Düşük görme, görme alanı testi, retinitis pigmentoza, trombositten zengin plazma, yaşam kalitesi

Platelet-rich plasma ınjection applications in patients with retinitis pigmentosa

Aim: To evaluate the effect of subtenon autologous platelet-rich plasma (PRP) injection on visual acuity, visual field and vision-related quality of life (QoL) in patients with Retinitis Pigmentosa (RP). Method: In this retrospective study, subtenon autologous PRP injections were applied to 60 eyes of 31 RP patients three times at two-week intervals between 2019- 2021. Best-corrected visual acuity (BCVA) and visual field values [(mean deviation (MD)) and pattern standard deviation (PSD)] were compared before and one month after PRP injections. An additional injection was applied to 36 eyes of 19 of these patients who were followed up six months after the last injection. In this group, BCVA, visual field values and vision-related QoL scores were compared before and after PRP. Results: Median (Q1- Q3) values for BCVA 0.80 (0.52- 1.30) before PRP, then 0.80 (0.50- 1.28) logMAR, for MD, first -30.26 (-31.10 – -28.56), then -29.79 (-31.13 – -28.61), for PSD, it was 6.27 (4.78 – 8.15), then 6.59 (4.90 – 8.06). The difference between BCVA and MD values was statistically significant (p <0.001, p = 0.037, respectively). The difference between BCVA and visual QoL before and after the first PRP injection in the group that received additional injections was statistically significant, but not significant for MD (p <0.005; p <0.001; p = 0.393; respectively). There were no ophthalmologic/systemic complications associated with the application. Conclusion: Subtenon autologous PRP injection may have a positive effect on visual functions and quality of life in patients with retinitis pigmentosa. However, studies with larger participation and longer follow-up periods are needed to determine the effectiveness of the treatment and the frequency of application

Keywords:

Low vision, platelet-rich plasma, quality of life, retinitis pigmentosa, visual field tests,

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